K
Ketone bodies, blood
Purpose of the test
Serum ketone levels are measured to evaluate ketoacidosis in patients with diabetes mellitus and for patients with ketoacidosis due to alcoholism, starvation, or high-protein diets. For patients with ketoacidosis associated with diabetes mellitus, ketone levels may be used to determine insulin requirements.
Basics the nurse needs to know
Serum ketone levels may be measured to distinguish between diabetic ketoacidosis and hyperosmolar coma. With diabetic ketoacidosis, incomplete fatty acid metabolism leads to increasing ketones in the blood. Patients with hyperosmolar coma and extremely high levels of serum glucose produce minimal to no measurable ketones. The mechanism of maintaining nearly normal ketone levels in hyperosmolar coma is not known. It is theorized that these patients have sufficient insulin to break down fatty acids or are glucagon resistant. Without adequate insulin, three major ketone bodies accumulate in the blood: acetone, acetoacetate acid, and β-hydroxybutyric acid.
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